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Renin-angiotensin system inhibitors prescriptions in Chinese hospitalized chronic kidney disease patients

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World Journal of Clinical Cases 2024年第17期12卷 3061-3075页

作者： Chun Zhang Zhi-Yu Duan Sa-Sa Nie Zhou Zhang Xin-Ru Guo Chao-yang Zhang Jing Dong guang-yan cai Department of Nephrology The First Medical CentreChinese PLA General HospitalBeijing 100853China School of Medicine Nankai UniversityTianjin 300071China National Engineering Laboratory for Medical Big Data Application Technology Chinese PLA General HospitalBeijing 100853China

BACKGROUND Many guidelines have recommended renin-angiotensin system inhibitors(RASI)as the first-line treatment for patients with chronic kidney disease(CKD).We studied RASI prescription trends from 2010 to 2019,and analyzed the characteristics associated with RASI prescription in Chinese hospitalized CKD *** To study the prescription of renin angiotensin system inhibitors in hospitalized patients with CKD in *** It was retrospectively,cross-sectional reviewed RASI prescriptions in hospitalized CKD patients in China from 2010 to *** prescribing trends were analyzed from 2010 to 2019,and bivariate and multivariate logistic regression analyses were conducted to identify characteristics associated with RASI *** A total of 35090 CKD patients were included,with 10043(28.6%)RASI *** these patients,18919(53.9%)met the criteria for RASI treatments based on the 2012 kidney disease:Improving global outcomes *** these,7246(38.3%)patients received RASI *** prescriptions showed an initial rapid increase from 2011 to 2012,reached its peak around 2015 and 2016,and then exhibited a subsequent slight decreasing *** bivariate and multivariate analyses showed that several characteristics,including the male gender,age less than 60-year-old,nephrology department admission,lower CKD stage,history of hypertension or diabetes,proteinuria,glomerulonephritis as the CKD etiology,and non-acute kidney injury were associated with RASI *** The frequency of RASI prescriptions showed an initial increase but a slight decreasing trend in more recent *** patients with certain characteristics such as elderly age,advanced disease stage,surgery department admission,or acute kidney injury were less likely to receive RASI *** the application of RASI in hospitalized CKD patients is *** actual clinical practice needs to be *** development of related research

关键词： Chronic kidney disease Renin-angiotensin system inhibitors Prescriptions Adherence

Establishment of submandibular gland allotransplantation model in miniature swine

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Chinese Medical Journal 2006年第6期119卷 482-487页

作者： GE Xi-yuan YU guang-yan cai Zhi-gang MAO Chi Department of Oral and Maxillofacial Surgery Peking UniversitySchool of Stomatology Beijing 100081 China

Background Autologous transplantation of the submandibular gland （SMG） into the temporal fossa with microvascular anastomosis has been successfully applied in severe xerophthalmia patients as a permanent tear substitute. However, severe xerophthalmia can be accompanied by salivary gland dysfunction, making such autotransplantation unsuitable. Therefore, SMG allotransplantation might be a solution. The aim of this study was to assess the technical feasibility of submandibular gland allotransplantation. Methods Twelve miniature swine were randomized to serve as donors or recipients. One SMG was transplanted between a donor and a recipient. The donor SMG was revascularized by microvascular anastomosis of its vascular pedicle to the recipient lingual artery and external jugular vein. The secretory duct was implanted into the vestibule of the mouth through a subcutaneous tunnel. No ilnmunosuppressive agent was administered. The results were assessed by visual inspection of the secretion, and histopathological examination of the transplanted SMG. Results Technically, all surgical procedures were successful. Clear secretion flowed out of the duct as soon as blood supply of the transplanted submandibular gland was reestablished. The secretion of the gland lasted for 5 days. As expected, an acute rejection reaction occurred after surgery because no immunosuppressive agents were used. Secretion from the transplanted SMG ceased within 5 days. Conclusions A model of SMG allotransplantation can be established in miniature swine. The technique of submandibular gland allotransplantation is feasible.

关键词： submandibular gland transplantation miniature swine animal model

Relationship between serum C3/C4 ratio and prognosis of immunoglobulin A nephropathy based on propensity score matching

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Chinese Medical Journal 2020年第6期133卷 631-637页

作者： yan Zhang Shu-Wei Duan Pu Chen Zhong Yin Yong Wang guang-yan cai Xiang-Mei Chen Department of Nephrology Chinese People's Liberation Army General HospitalChinese People's Liberation Army Institute of NephrologyState Key Laboratory of Kidney DiseasesNational Clinical Research Center for Kidney DiseasesBeijing Key Laboratory of Kidney Disease ResearchBeijing 100853China

Background:Aberrant activation of the complement system plays an important role in the pathogenesis and development of immunoglobulin A nephropathy(IgAN).The relationship between serum complement and the clinical-histopathological features and outcomes of IgAN is *** retrospective study aimed to examine the relationship between the complement 3/4(C3/C4)ratio and the clinicopathologic changes and prognosis of patients with ***:A total of 397 patients with primary IgAN from January 2007 to December 2012 at the Chinese People's Liberation Army General Hospital were included in this *** correlation test and Chi-square test or one-way analysis of variance test were performed to evaluate the relationship between the C3/C4 ratio and other clinical-pathological *** score matching and a multivariate Cox regression model were used to calculate the risk factors of renal ***:The median follow-up period was 75 *** the follow-up period,62 patients(15.6%)developed into the endstage renal disease(ESRD).The C3/C4 ratio at baseline was associated with the level of serum creatinine(SCr),24 h urinary protein excretion(24 h Upre),global glomerular sclerosis,and tubulointerstitial *** level of SCr and 24 h Upre and the degree of chronic kidney injury were statistically different among groups defined by different C3/C4 ratio *** survival rates of patients among groups with different C3/C4 ratio levels were *** propensity score matching,eighty-eight pairs of patients were successfully matched,and the C3/C4 ratio was an influencing factor for the patients5 outcome(hazard ratio 0.587,95%confidence interval 0.329-0.880).Patients with a C3/C4 ratio<3.6 had a poorer outcome compared with the others(P=0.002).Conclusions:IgAN patients with decreased C3/C4 ratio displayed significantly more severe clinical symptoms and chronic renal injury than patients with higher ratios.A low C3/C4 ratio could be a risk

关键词： Complement Serum C3/C4 Immunoglobulin A nephropathy Prognosis

Progress of small ubiquitin-related modifiers in kidney diseases

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Chinese Medical Journal 2019年第4期132卷 466-473页

作者： Ou Li Qian Ma Fei Li guang-yan cai Xiang-Mei Chen Quan Hong Department of Nephrology Chinese PLA General HospitalChinese PLA Institute of NephrologyState Key Laboratory of Kidney DiseasesNational Clinical Research Center for Kidney DiseasesBeijing Key Laboratory of Kidney DiseasesBeijing 100853China.

Objective: Small ubiquitin-related modifiers (SUMOs) are a group of post-translational modification proteins extensively expressed in eukaryotes. Abnormal SUMOylation can lead to the development of various diseases. This article summarizes the progress on research of the role of SUMOs in various types of kidney diseases to further increase the understanding of the regulatory functions of SUMOylation in the pathogenesis of kidney diseases. Data sources: This review was based on articles published in the PubMed databases up to January 2018, using the keywords including "SUMOs," "SUMOylation," and "kidney diseases." Study selection: Original articles and critical reviews about SUMOs and kidney disease were selected for this review. A total of 50 studies were in English. Results: SUMO participates in the activation of NF-κB inflammatory signaling pathway, playing a central regulatory role in the inflammation and progression of DN, and the secretion of various chemokines in AKI. SUMO involves in the regulation of TG2 and Nrf2 antioxidant stress, affecting renal tubular injury in AKI. SUMO affects the MAPK/ERK pathway, regulating intracellular signal transduction, modulating the transcription and expression of effector molecules in DN. SUMO contributes to the TGF-β/Smad pathway, leading to fibrosis of the kidney. The conjugate combination of SUMO and p53 regulates cell proliferation and apoptosis, and participates in the regulation of tumorigenesis. In addition, SUMOylation of MITF modulates renal tumors secondary to melanoma, Similarly, SUMOylation of tumor suppressor gene VHL regulates the occurrence of renal cell carcinoma in VHL syndrome. Conclusions: Tissue injury, inflammatory responses, fibrosis, apoptosis, and tumor proliferation in kidney diseases all involve SUMOs. Further research of the substrate SUMOylation and regulatory mechanisms of SUMO in kidney diseases will improve and develop new treatment measures and strategies targeting kidney diseases.

关键词： Small ubiquitin-related modifiers SUMOylation Kidney diseases

Single-cell RNA sequencing data suggest a role for angiotensin-converting enzyme 2 in kidney impairment in patients infected with 2019-novel coronavirus

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Chinese Medical Journal 2020年第9期133卷 1129-1131页

作者： Yi-Yao Deng Ying Zheng guang-yan cai Xiang-Mei Chen Quan Hong Department of Nephrology Chinese People’s Liberation Army General HospitalChinese People’s Liberation Army Institute of NephrologyState Key Laboratory of Kidney DiseasesNational Clinical Research Center for Kidney DiseasesBeijing Key Laboratory of Kidney DiseasesBeijing 100039China

The World Health Organization has recently declared the 2019-novel coronavirus(2019-nCoV)a global public health *** et al[1]reported acute kidney injury(AKI)in 7%of the 41 patients infected with 2019-nCoV,this value was even higher(up to 31%)among intensive-care ***,Li et al[2]reported that plasma creatinine levels increased in 11 of 59 patients with 2019-nCoV infection,suggesting that kidney function was probably impaired when the disease *** et al[3]reported that plasma creatinine level increased in 4.3%of severely diseased patients.2019-nCoV is a highly contagious pathogen that predominantly causes pneumonic *** respiratory failure has been associated with the highest mortality,the lung was not the only organ *** et al[4]reported that 2019-nCoV and severe acute respiratory syndrome-associated coronavirus(SARS-CoV)share a common receptor angiotensin-converting enzyme 2(ACE2)that is required to enter target cells,and cellular protease transmembrane protease serine 2(TMPRSS2)can cleave and activate the spike protein of 2019-nCoV for membrane *** investigated whether ACE2 and TMPRSS2 were expressed in kidney cells using precisiontechnology single-cell RNA sequencing.

关键词： ACE2 patients kidney

Clinical Analysis of a Hypokalemic Salt-losing Tubulopathy Case

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Chinese Medical Journal 2016年第5期129卷 601-603页

作者： Wei Zheng Quan Hong Xue-guang Zhang Xiao-Dong Geng guang-yan cai Xiang-Mei Chen Di Wu Department of Nephrology Chinese People's Liberation Army General Hospital Chinese People's Liberation Army Institute of Nephrology State Key Laboratory of Kidney Diseases National Clinical Research Center for Kidney Diseases Beijing Key Laboratory of Kidney Disease Beijing 100853 China

Hypokalemia is among the most common electrolyte disorders in clinical practice and severe condition is life-threatening and has received extensive attention in clinical practice. Genetic diagnosis remains the gold standard for the diagnosis and identification of hereditary renal tubular diseases. Below is the report of genotyping and diagnosis of a case of secondary Gitelman syndrome （GS） based on next-generation sequencing.

关键词： Diagnosis Gene Screening Hypokalemia

A non-invasive diagnostic model of immunoglobulin A nephropathy and serological markers for evaluating disease severity

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Chinese Medical Journal 2019年第6期132卷 647-652页

作者： Qiu-Xia Han Yong Wang Han-Yu Zhu Dong Zhang Jing Gao Zhang-Suo Liu guang-yan cai Xiang-Mei Chen Department of Nephrology The First Affiliated Hospital of Zhengzhou University Research Institute of Nephrology in Zhengzhou University Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province Zhengzhou Henan 450052 China Department of Nephrology Chinese People's Liberation Army General Hospital Chinese People's Liberation Army Institute of Nephrology State Key Laboratory of Kidney Diseases National Clinical Research Center for Kidney Diseases Beijing Key Laboratory of Kidney Diseases Beijing 100853 China Department of Clinical Biochemistry Chinese People's Liberation Army General Hospital Beijing 100853 China

Background: Immunoglobulin A nephropathy (IgAN) is the most common pathological type of glomerular disease. Kidney biopsy, the gold standard for IgAN diagnosis, has not been routinely applied in hospitals worldwide due to its invasion nature. Thus, we aim to establish a non-invasive diagnostic model and determine markers to evaluate disease severity by analyzing the serological parameters and pathological stages of patients with IgAN. Methods: A total of 272 biopsy-diagnosed IgAN inpatients and 518 non-IgA nephropathy inpatients from the Department of Nephrology of Chinese People's Liberation Army General Hospital were recruited for this study. Routine blood examination, blood coagulation testing, immunoglobulin-complement testing, and clinical biochemistry testing were conducted and pathological stages were analyzed according to Lee grading system. The serological parameters and pathological stages were analyzed. The receiver operating characteristic (ROC) analysis was performed to estimate the diagnostic value of the clinical factors. Logistic regression was used to establish the diagnostic model. Results: There were 15 significantly different serological parameters between the IgAN and non-IgAN groups (all P< 0.05). The ROC analysis was performed to measure the diagnostic value for IgAN of these parameters and the results showed that the area under the ROC curve (AUC) of total protein (TP), total cholesterol (TC), fibrinogen (FIB), D-dimer (D2), immunoglobulin A (IgA), and immunoglobulin G (IgG) were more than 0.70. The AUC of the "TC + FIB + D2 + IgA + age" combination was 0.86, with a sensitivity of 85.98% and a specificity of 73.85%. Pathological grades of Ⅰ,Ⅱ,Ⅲ,Ⅳ, and Ⅴ accounted for 2.21 %, 17.65%, 62.50%, 11.76%, and 5.88%, respectively, with grade Ⅲ being the most prevalent. The levels of urea nitrogen (UN)(13.57土 5.95 vs. 6.06 土 3.63, 5.92 + 2.97, 5.41 ± 1.73, and 8.41 ±3.72μmol/L, respectively) and creatinine (Cr)(292.19± 162.21 vs. 80.42±24.75, 103.79±7

关键词： Immunoglobulin A nephropathy Noninvasive Diagnostic model Severity

Embryonic Stem Cells-loaded Gelatin Microcryogels Slow Progression of Chronic Kidney Disease

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Chinese Medical Journal 2016年第4期129卷 392-398页

作者： Xiao-Dong Geng Wei Zheng Cong-Mei Wu Shu-Qiang Wang Quan Hong guang-yan cai Xiang-Mei Chen Di Wu Department of Nephrology Chinese People's Liberation Army General Hospital Chinese People's Liberation Army Institute of Nephrology State Key Laboratory of Kidney Diseases National Clinical Research Center for Kidney Diseases Beijing Key Laboratory of Kidney Disease Beijing 100853 China Department of Biotechnology School of Chemistry and Life Science Changchun University of Technology Changchun Jilin 130012 China

Background： Chronic kidney disease （CKD） has become a public health *** interventions to slow or prevent disease progression are urgently *** this setting, cell therapies associated with regenerative effects are attracting increasing *** evaluated the effect of embryonic stem cells （ESCs） on the progression of ***： Adult male Sprague-Dawley rats were subjected to 5/6 *** used pedicled greater omentum flaps packing ESC-loaded gelatin microcryogets （GMs） on the 5/6 nephrectomized *** viability of ESCs within the GMs was detected using in vio two-photon fluorescence confocal *** were sacrificed after 12 *** injury was evaluated using serum creatinine, urea nitrogen, 24 h protein, renal pathology, and tubular injury score *** damage was evaluated by periodic acid-Schiff and Masson trichrome ***： In vitro, ESCs could be automatically loaded into the *** cell distribution, good cell attachment, and viability were achieved from day 1 to 7 in *** 12 weeks, in the pedicled greater omentum flaps packing ESC-loaded GMs on 5/6 nephrectomized rats group, the plasma urea nitrogen levels were 26% lower than in the right nephrectomy group, glomerulosclerosis index was 62% lower and tubular injury index was 40% lower than in the 5/6 nephrectomized rats group without ***： In a rat model of established CKD, we demonstrated that the pedicled greater omentum flaps packing ESC-loaded GMs on the 5/6 nephrectomized kidney have a long-lasting therapeutic rescue function, as shown by the decreased progression of CKD and reduced glomerular injury.

关键词： Chronic Renal Insufficiency Embryonic Stem Cells Gelatin Microcryogels Regenerative Medicine

Potential Value of Datura stramonium Agglutinin-recognized Glycopatterns in Urinary Protein on Differential Diagnosis of Diabetic Nephropathy and Nondiabetic Renal Disease

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Chinese Medical Journal 2018年第2期131卷 180-187页

作者： Xiao-Li yang Han-Jie Yu Han-Yu Zhu Ying Zheng Qiu-Xia Han guang-yan cai Xiang-Mei Chen 'Department of Nephrology Chinese People's Liberation Army General Hospital Chinese People's Liberation Army Institute of NephrologyState Key Laboratory of Kidney Diseases (2011DAVO0088) National Clinical Research Center for Kidney Diseases Beijing Key Laboratory of Kidney Diseases Beijing 100853 China Laboratory for Functional Glycomics College of I'ifeSciences Northwest University Xi'an Shaanxi 710069 China Department of Nephrology The First Affiliated Hospital of Zhengzhou University Zhengzhou Henan 450052 China

Background： Diabetic nephropathy （DN） is the most common and serious microvascular complication of diabetes. To date, the gold standard for identifying DN and nondiabetic renal disease （NDRD） is a renal biopsy; however, there is currently no reliable diagnostic marker to identify DN and NDRD in a noninvasive manner. This study aimed to investigate the different glycopatterns in urine specimens of DN patients and NDRD patients for a differential diagnosis. Methods： In total, 19 DN patients and 18 NDRD patients who underwent renal biopsies between March 2015 and March 2016 at the Chinese People＇s Liberation Army General Hospital were enrolled in this study. A lectin microarray was used to investigate the glycopatterns in the urinary protein of the 37 patients. Ratio analysis and one-way analysis of variance were used to screen altered glycopatterns. Then, the altered glycopatterns between the DN and NDRD groups were verified by a urinary protein microarray among another 32 patients （15 with DN and 17 with NDRD）, and receiver operating characteristic （ROC） curve analysis was used to determine the diagnostic value of the altered glycopatterns in differentiating DN and NDRD. Finally, lectin blotting was used to evaluate the altered glycosylation in protein level. Results： The result of lectin microarrays revealed that the relative abundance of the （13-1,4）-linked N-acetyI-D-glucosamine （GlcNAc） recognized by lectin Datura stramonium agglutinin （DSA） was significantly higher in urinary protein in DN patients than that in NDRD patients （fold change 〉1.50, P 〈 0.001）. Subsequently, the results of urinary protein microarrays were consistent with lectin microarrays （P 〈 0.05）. Furthermore, the ROC curve showed that glycopatterns could effectively distinguish DN from NDRD patients （area under the ROC curve = 0.94, P 〈 0.001）. DSA lectin blotting showed that glycoproteins, with a molecular weight of approximately 50,000, demonstrated a difference in urine samples between DN pat

关键词： Diabetic Nephropathy: Glycopattern NondiabeticRenal Disease, Urinary Protein